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Peripheral Versus Intraparenchymal Papillary Thyroid Microcarcinoma: Different Morphologies and PD-L1 Expression

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Abstract

Peripheral localisation of papillary thyroid microcarcinoma (PTMC), in comparison with intraparenchymal PTMC (i-PTMC) is related to some clinicopathological features related with biological aggressiveness, including lymph node metastasis (LNM). The expression of PD-L1 in tumour cell has been associated with increased tumour survival, progression, and potentially an aggressive clinical course. This study evaluates the relation between clinicopathological features of PTMC, including tumour localisation, with PD-L1 immunoexpression. The study included 99 patients with the histological diagnosis of PTMC (≥ 5 mm). PD-L1 protein expression was assessed by immunohistochemistry. PTMCs were divided into the four following groups: G1– peripherally localised PTMC (p-PTMC) with PD-L1 expression; G2–p-PTMC without PD-L1 expression; G3–i-PTMC with PD-L1 expression and G4–i-PTMC without PD-L1 expression. G1 was the most frequent (n = 46; 46.5%), followed by G4 (n = 25; 25.3%) and similar distribution of G3 (n = 15; 15.2%) and G2 (n = 13; 13.1%). In comparison with other groups, G1 was significantly associated with classical morphology, invasive growth, lymphatic invasion (LI), vascular invasion (VI), psammoma bodies, intratumoral fibrosis, PD-L1 positive tumour-infiltrating lymphocytes, and multinuclear giant cells (MGCs). G4 more commonly exhibited follicular morphology, expansive/circumscribed growth, and absence of the following: intratumoural fibrosis, LI, VI, psammoma bodies, PD-L1 positive tumour-infiltrating lymphocytes, and MGCs. LNMs were significantly more frequent in G1 in comparison with the other groups (p = 0.000). In conclusion, morphology and tumour microenvironment of p-PTMC with PD-L1 expression is different from i-PTMC without PD-L1 expression. The differences between these two groups of PTMC include clinicopathological features related with biological aggressiveness such as the occurrence of LNM.

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Data Availability

The data set generated and/or analyzed during the current study are available from the corresponding author.

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Authors and Affiliations

  1. Institute of Pathology and Forensic Medicine, Military Medical Academy, Crnotravska 17, 11000, Belgrade, Serbia

    Bozidar Kovacevic & Snezana Cerovic

  2. Institute for the Application of Nuclear Energy – INEP, University of Belgrade, Belgrade, Serbia

    Dragana Vucevic

  3. Ipatimup Diagnostics, Institute of Molecular Pathology and Immunology of Porto University, Ipatimup, Porto, Portugal

    Catarina Eloy

  4. Medical Faculty, University of Porto, Porto, Portugal

    Catarina Eloy

  5. Instituto de Investigação E Inovação Em Saúde (i3S), University of Porto, Porto, Portugal

    Catarina Eloy

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  1. Bozidar Kovacevic
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  4. Catarina Eloy
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Contributions

BK, DV, and SC contributed to the study conception and design. Material preparation, data collection and analysis were performed by BK, and SC. The first draft of the manuscript was written by BK and all authors commented on previous versions of the manuscript. The scientific editing and final revision of the manuscript were performed by CE. All authors read and approved the final manuscript.

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Correspondence to Bozidar Kovacevic.

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Conflict of interest

The authors declare no potential conflicts of interest with respect to research, authorship, and/or publication of this article.

Ethics Approval

This work was performed in archived paraffin tissue that remained from the diagnosis of the thyroid samples of patients that were anonymized. The materials used for the work are not needed for diagnosis in the present nor in the future. The Ethics Committee of the Military Medical Academy and University of Defence, Serbia, approved this study (Number: 16–71; 5/29/2019).

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Kovacevic, B., Vucevic, D., Cerovic, S. et al. Peripheral Versus Intraparenchymal Papillary Thyroid Microcarcinoma: Different Morphologies and PD-L1 Expression. Head and Neck Pathol 16, 200–212 (2022). https://doi.org/10.1007/s12105-021-01337-1

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